Too much power for care home managers under mental health reforms, warns Labour

Richard Wheeler and Josh Thomas, Press Association Political Staff

The Bill aims to replace the current deprivation of liberty safeguards scheme with a new, simpler system.

Care home managers will still receive too much power under reforms linked to the detention of vulnerable people, according to Labour.

Shadow health minister Barbara Keeley said improvements have been made to the Mental Capacity (Amendment) Bill by peers but “serious flaws” remain.

She highlighted mistreatment of residents at Mendip House, a care home for autistic adults, and questioned how the Government will meet its commitment to ensure people’s wishes are always respected given that a care manager “neglected care planning and safeguarding” in this instance.

The Bill aims to replace the current deprivation of liberty safeguards scheme with a new, simpler system.

Critics initially raised concerns over the meaning of deprivation of liberty proposed by ministers, with the Government saying it remains “committed to providing clarification”.

Health minister Caroline Dinenage added that a code of practice will outline when a deprivation of liberty is and is not occurring, with the guidance reflecting existing case law.

Ms Dinenage also told the Commons: “We now have an opportunity to deliver reforms that will provide quicker and fuller access to protections for the 125,000 people who are not currently receiving them.

“That is 125,000 vulnerable people without the legal protection that they deserve, 125,000 people whose families do not have the peace of mind, and 125,000 people for whom their care providers have no legal cover to be supporting them.

“We now have an opportunity to rectify this.”

But Ms Keeley said: “The Bill still places more power than it should in the hands of care home managers.

“From organising assessments to carrying out consultations with the cared-for person, the Bill means an untrained care home manager or an ineffective one could end up carrying out the process in a flawed or improper way.

“There was recently a focus on the scandal of abuse which happened at the Mendip House care home in Somerset, with six residents who were autistic people with complex needs.

“The safeguarding adult review carried out by the Somerset Safeguarding Board revealed a host of management failures by the National Autistic Society.

“The registered manager of that particular care home did not address the unprofessional behaviour of a thuggish gang of male staff, and this resulted in the following abuse being meted out to residents in Mendip House: residents were ridden like horses by staff; were forced to crawl on all fours; were made to eat raw chillies; and in one horrific instance forced to eat food spiked with mustard which caused the resident to vomit – the resident was then made by a member of staff to drink the vomit.

“People living in Mendip House had complex needs and all would have lacked capacity to make certain decisions, and all required DoLS (deprivation of liberty safeguards).

“The CQC had not received any notification that any DoLS had been authorised.”

Ms Keeley added it was important people know as soon as possible what is happening in cases of deprivation of liberty.

Giving an example, she said: “This was the case where a young man, Oliver McGowan, died because he was given anti-psychotic medication to which he had reacted and which caused his death, despite express warnings about its possible effect on him.

“What we only recently found out is that the Mental Capacity Act was not used appropriately in Oliver’s case. The DoLS authorisation for his treatment was applied for after he was given the anti-psychotic drug Olanzapine against the express wishes of both Oliver and his parents, and he suffered an adverse reaction to the drug which led to his death.”

Ms Keeley said it is important to safeguard against people being held under DoLS “for weeks, without the legal basis for detaining them being explained”.

The Bill was amended without a vote and is expected to return to the Lords for further scrutiny.